How U.S. historical medical mistreatment underpins COVID-19 vaccine Black skepticism

OPINION: Unethical and abusive medical experimentation is merely one of the root reasons undergirding Black disengagement with the healthcare system

COVID-19 has positioned African Americans in a crisis within a crisis. According to the Centers for Disease Control (CDC), to date, there have been an estimated upwards of 37 million total reported cases of COVID-19 and 600,000 deaths. African Americans account for 13% of the U.S. population, however, disproportionately represent 20% of COVID-19-related deaths as of May.

After its initial wave, the emergence of the COVID-19 delta variant continues to loom over Black Americans navigating ways to protect themselves and their loved ones.

Despite an earnest call for COVID-19 vaccinations by government officials and medical professionals, the Black community is seemingly presented with choosing between the lesser of two evils. On one hand, there is a life-threatening virus, and on the other hand — they must contend with trusting medical institutions that have historically done more harm than good.

The data is daunting, and yet, statistically African Americans remain skeptical regarding the COVID-19 vaccine compared to whites. Reports indicated by kff.org show an estimated 40% of African Americans have received at least one shot of the COVID-19 vaccination compared to 50% of whites.

If one were to look for a reason for such doubt, look no further than history. While there may be many reasons contributing to lowered numbers of vaccinations in the African American community, the historical dehumanization of the Black body at the hands of the American medical institutions certainly is one to consider.

America has been negligent in its ability to care for all of its citizens in a manner that can be considered as “equitable,” and until there is a significant decrease in racial healthcare disparities in this country, will remain skeptical of governmental interest in their “care.” The shameful history of this negligence has been well documented, and perhaps, it is not improper for many Blacks to remain cynical about healthcare in general.

Dating back to the American slave trade, Black bodies have been exploited and experimented on in the name of science and medicine. These actions were completely sanctioned by the United States government and the medical establishment. Black people were left vulnerable as there was no protection or moral initiative to stop the harm against them.

Evidence of this can be seen in the treacherous work of American physician and slaveholder J. Marion Sims in the 19th century. He developed a treatment for Vesicovaginal fistula, or VVF, a condition causing an abnormality in the opening between the bladder and the wall of the vagina and incontinence. His agonizing procedures experimented on enslaved women without anesthesia or consent. They were invasive and abusive gynecological exams that treated Black women as nothing more than lab rats for white profit and gain.

A tainted and traumatic past

The 1910 Flexner Report that generated findings from a biased research endeavor that targeted Black-owned schools led to the cessation of almost all Black-owned medical schools in the country. We also cannot forget about the famous Tuskegee study of untreated syphilis in Black males only two decades (1932-1972) after all Black-owned medical schools were shut down.

Then as early as the 1990s, Black boys were unethically targeted and subjected to abusive medical methodologies, such as withholding water, overnight stay without parents, and ingesting harmful substances to test their genetic propensity for violence.

But, unethical and abusive medical experimentation is merely one of the root reasons undergirding Black disengagement with the healthcare system. Institutional biases, racial myths and stereotypes often perpetuate a vicious pattern of health disparities.

Institutional bias, misconceptions and myths

Unfortunately, the medical profession has much work to do in reconciling with its history of anti-Blackness. Still today, studies illustrate medical professionals are influenced by biased perceptions that Black people feel less pain, are more likely to abuse drugs and are less intelligent than white patients.

In research analyzing health disparities in pain treatment conducted by Kelly M. Hoffman, Sophie Trawalter, Jordan R. Axt, and M. Norman Oliver, Black patients were often grossly undertreated compared to white patients. Their study illuminated white medical professionals’ misconceptions of biological differences between Black and white patients and their biased beliefs that Black patients’ pain tolerance was higher than whites.

An honest reconciliation from a Black perspective

To fully understand and correct this peculiar conundrum Black people are up against, the white-dominated medical institution must be willing to push past its ‘white fragility and guilt’ and go much further beyond surface-level solutions.

These institutions must then be gutted and redesigned with an empathetic and human approach to establish a relationship of trust, and start the cycle of healing from the intergenerational trauma that Black people have endured. Medical professionals, researchers, students, and all healthcare workers need a formal education process on this history and cultural sensitivity to improve the quality of care for patients of color.

Until this occurs systematically, the appearance of what some would consider the interesting patterns of an iterative history of Blackness being a risk factor for deadly diseases has many Black people, justifiably, concerned. The United States’ history of health-based racial discrimination validates our skepticism, and the high mortality rate of Black people during COVID-19 is a resounding signal that we should and will remain vigilantly skeptical.

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